0. Creating New Pathways in HIT Workforce Development
EU-US eHealth/Health IT Cooperation Initiative Workforce Development Work Group
Creating New Pathways in HIT Workforce Development
DRAFT

1. HIT Workforce Development
Background: EU-US eHealth Collaboration Initiative Memorandum of Understanding (DRAFT)
It started with a Memorandum of Understanding
In December 2010, the European Commission and the US Department of Health and Human Services signed a Memorandum of Understanding (MOU) to:
Help facilitate more effective uses of eHealth/Health IT;
Strengthen their international relationship; and
Support global cooperation in the area of health related information and communication technologies
Doug
HIT Workforce Development

2. Genesis of the EU-US eHealth Collaborative Initiative (DRAFT)
In June 2013, an key stakeholders and interested parties were invited to participate in the EU-US eHealth Collaborative Initiative
In August 2013, two work groups were launched, from the two initiative work streams of Interoperability and Workforce Development

3. Workforce Development Community (DRAFT)
Work Group Members represent 13 countries
Canada
England
Finland
France
Germany
Greece
Ireland
Israel
Italy
Mexico
Norway
Scotland
United States
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4. EU-US eHealth Collaborative Initiative Vision (DRAFT)
The vision and roadmap set the framework for progress
Vision
“To support an innovative collaborative community of public- and private-sector entities working toward the shared objective of developing, deploying, and using eHealth science and technology to empower individuals, support care, improve clinical outcomes, enhance patient safety and improve the health of populations.”
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5. Workforce Development Vision (DRAFT)
The Workforce Development work group aims to develop a skilled Health IT workforce in the EU and US
Goal of the Workforce Development Work Group:
“To achieve a robust supply of health professionals highly proficient in the use of health IT, assuring healthcare, public health and allied professional work forces have the technology skills needed to enhance their professional experience and performance with eHealth/Health IT”
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6. Workforce Development Roadmap (DRAFT)
From the Memorandum of Understanding, a roadmap was created to help guide the work of the Workforce Development Work Group
The Roadmap contains these major tasks:
Identify Project Champions
Complete analysis of competencies required by the diverse healthcare and eHealth/IT workforce
Identify and map curricula that addresses the competencies identified in the US and EU
Explore new models of education/employer collaboration
Pilot innovative ways to develop a healthcare IT workforce
These tasks were broken down into the following key milestones:
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7. Roadmap Milestones (DRAFT)
Assessment of the scope, scale and characteristics of the healthcare workforce in the US and EU, and assessment of healthcare settings  
Categorize Health Care Settings into domains, and map to HIT-related roles in the EU and US
Collect Competencies from various EU and US Sources to evaluate and map to roles  
Define HIT Competencies for domains, assign levels, and integrate Bloom’s Taxonomy (completed for Direct Patient Care – Clinical bucket)
Identify and map learning resources that promote competencies identified in the US and EU; develop white paper
Create a needs analysis that looks at what current formal and informal curricula and training exist, identify the gaps, and develop solutions to bridge the gap
Define and agree upon common eHealth standards of competence and professionalism
Ongoing
Completed
Completed
Ongoing
Rachelle
November 2014
March 2015
Ongoing

8. Workforce Development Proposed Project Timeline (all dates are tentative) (DRAFT)
January 2014
March
June 2013
September
May
Finalized applying Classifications to Competencies; defined domains, levels and buckets (03/31)
Finalized first Role to Competency Mapping (4/24)
Presented work at eHealth Week in Athens (5/14)
Kick-off eHealth Cooperation Initiative (6/20)
Launch of Workforce Development Sub Workgroup (8/20)
Group reached agreement on Health IT Setting (9/12)
Group reached agreement on Classification Schema for Competencies and Roles (11/12)
Finalized mapping Roles to Classification Scheme Setting (01/02)
July 2014
August
September
October
November
January 2015
March 2015
Rachelle
Develop solutions to bridge gaps; create interactive tools; devise pilot(s) (3/5 onward)
Begin to Draft White Paper for Peer Review and potential publication on Methodology and Process; Communicate Progress to Stakeholders (9/4)
Finalize second domain Competency Mapping (11/30)
Finalized all Direct Patient Care Domain mapping (7/10)
Begin Curriculum to Competency Gap Analysis and Mapping (8/6)
Present at eHealth Week in Boston (Oct 21-22)
Finalize work on curriculum needs/gap analysis (1/29)
Key: Completed In Progress Future

9. Bridging the Gaps Between Healthcare IT and Health Information Management (DRAFT)
The EU-US Workforce Development Workgroup, in Creating New Pathways in Health Information Technology, is helping to bridge the gaps between traditional healthcare roles, information technology roles and healthcare information management roles

10. Bridging the Gaps Between Healthcare IT and Health Information Management (cont’d) (DRAFT)
One of the ways in which the WDW does this is by mapping areas where information technology “touches” traditional healthcare roles (in addition to mapping roles and skills usually associated with healthcare IT, such as HIM, clinical informatics, administration, etc.)
These HIT competencies supplement the core skills in many areas of healthcare delivery not commonly associated with information technology
Examples:
Nurse Core Skills:
Patient Care
Clinical Interventions
Care Protocols
Medication Delivery
Triaging
Vital Sign Assessments
Wound Care …
Nurse HIT Skills:
Clinical Decision Support
Orders Management
Electronic Documentation
Bar Code Administration
Medication Reconciliation …
Pharmacist Core Skills:
Drug Compounding
Drug Distribution
Intravenous Preparations
Prescription Processing
Prescription Packaging …
Pharmacist HIT Skills:
Order Processing and Management
Clinical Decision Support Build
Electronic Distribution Systems Management
Medication Systems Implementation …

11. The Skills Mapping Forms a Competency Framework (DRAFT)
A competency framework is based on skill sets used as building blocks. It could be shown in a progression such as this…
However, a competency level needs to be able to accommodate a variety of roles and job types

12. Competency Framework Progress to Date (DRAFT)
To date, we have accomplished the following tasks and subtasks in the mapping of skill areas:
Developed classification schema for HIT areas, roles, competencies and levels
Classified over 3000 competencies, with comprehensive mapping across 14 silos
Categorized healthcare roles into domains, levels and buckets
Created proof of concept competency mapping, including developing competencies, assigning levels, codifying and integrating Bloom’s taxonomy for over 250 Direct Patient Care – Clinical competencies
Begun an HIT curriculum requirement and gap analysis, identifying and mapping both formal and informal educational resources and needs

13. Current Work Streams (DRAFT)
Classification Schema: Roles, Silos, Domains, Subdomains/Buckets, Levels and Competency Areas
Roles: We mapped a variety of roles in acute care, across the European Union and the United States.
Update eu roles to include other names for roles

14. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Silos
Silos: We have collated over 3000 competencies from 14 derivative areas for competencies and curricula, including AHIMA-AMIA, IMIA, US Department of Labor, National Health Service UK (NHS-UK), Cuyahoga Community College, Texas HIT, HIMSS worldwide, and the European e-Competency Framework and others
AHIMA/AMIA
IMIA
DOL
NHS-UK
Additional UK Resources/Scottish Government
American Academy of Nurses
Cuyahoga CC
America’s Job Bank
Texas HIT
HealthIT.gov
European e-Competence Framework
NOS-UK
HIMSS worldwide
Created Competencies

15. Current Work Streams (cont’d) (DRAFT)
From each silo, hundreds of competencies were reviewed, categorized into domains, and finalized after subject matter expert review and group consensus
Identify classification and systematic health-related terminologies for coding and information retrieval.
Differentiate data versus information
AHIMA/AMIA
Describe the differences between health data and health information (EB01)
Understand terminologies used in electronic health records and health information technology pertinent to your role (EB02)

16. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Domains
Domains: We developed 5 domains of HIT settings, including Direct Patient Care, Administration/Finance/Law/ Management, Engineering/Information Systems, Informatics and Research
HIT Domains
Direct Patient Care
Admin/ Finance/ Law/Mgmt
Engineering/ Info Sys
Health Informatics
Research

17. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Subdomains/Buckets
Buckets: We then broke the domains down, dividing them into subdomains such as Professional/Operational/Managerial; clinical/non-clinical; revenue/compliance, etc.
Professional/ Operational/ Management
Clinical/
Non-Clinical
HIT Domains
Direct Patient Care
Admin/ Finance/ Law/Mgmt
Engineering/ Info Sys
Health Informatics
Research

18. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Subdomains/Buckets
Buckets: We broke the domains down, dividing them into subdomains such as Professional/Operational/Managerial; clinical/non-clinical; and revenue/compliance. From these subdomains, we grouped the roles and competency relationships down into buckets.
Audiologiste
Assistant Ärztin
Chiropodist
Registered Nurse
ausiliario socio-assistenziale
Lab Tech
Direct Patient Care - Clinical

19. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Levels
Levels: We classified the competencies into five levels: Baseline, Basic, Intermediate, Advanced and Expert. To assist us in this effort, we incorporated Bloom’s taxonomy to help determine the appropriate level for a competency.
Baseline
Basic
Intermediate
Advanced
Expert
Competency Levels

20. Current Work Streams (cont’d) (DRAFT)
Interoperability is the backbone of Health IT – it ensures interoperability of our work when we use existing standards
Bloom's Taxonomy of Educational Objectives provides standard classifications for the many nebulous terms often encountered in competency/curriculum development and evaluation
The interoperability of this process can be leveraged when mapping competencies and curriculum (using the Blooms Taxonomy), or when consolidating this work with similar initiatives, etc.
Seminal work in educational competency identification and measurement by Benjamin S. Bloom and his colleagues at the University of Chicago in the early 1950s led to a theoretical framework to facilitate communication about curriculum development and assessment among educators.6 Bloom's Taxonomy of Educational Objectivesprovided a set of standard classifications to facilitate definition of the many nebulous terms often encountered in curriculum development and evaluation initiatives.6 The framework was used to address educational outcomes in three major areas:
Cognitive domain. Those outcomes/objectives that deal with recall or recognition of knowledge and the development of intellectual abilities and skills. (This domain today remains the one most central to traditional curriculum development programs and to standardized test development and instrumentation.)
Affective domain. Objectives that describe changes in interest, attitudes, and values and the development of appreciation and adequate adjustment. (This domain is often the most difficult to describe due to the lack of clarity and agreement among educators in their specification of appropriate behaviors for assessment. As well, procedures used in this domain remain somewhat primitive by today's evaluation standards.)
Psychomotor domain (physical skills). Those objectives addressing manipulative or motor skill areas, i.e., ice skating, surgical procedures, etc. (This was the last of the three educational domains to be classified in the 1970s.)
Bloom’s Taxonomy Wheel

21. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Levels
After deciding the competency levels, we applied Bloom’s taxonomy to the competencies, with each level corresponding to a Bloom’s level
Expert
Advanced
Intermediate
Basic
Baseline
Synthesizing
Evaluating
Analyzing
Applying
Understanding
Knowing
Competency Level
Bloom’s Taxonomy

22. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Competency Areas
Competency Areas: We broke the competencies down into 20 major areas of concentration

23. Current Work Streams (cont’d) (DRAFT)
Classification Schema: Competency Areas
Competency Areas: The competencies can also be broken down into four areas of interactions. This helps with alignment with other workforce development initiatives:
Health Data
Access to Information
Data Compiling, Analysis and Reporting
General HIT Knowledge
Policies and Procedures
Privacy and Security
Clinical
Clinical Decision Support
Clinical Practice and Workflows
Documentation Process
Medications and Allergies
Order Entry
Patient
Care Coordination
Patient Access and Engagement
Population Mgmt/Public Health
Protected Health Information/Patient ID
Quality and Safety
Communications
Coding and Terminologies
Communications and Change Mgmt
eHealth/mHealth/Telehealth
Issue Management
HIE/Interoperability/Interfaces

24. Bringing it All Together
(DRAFT)
We have taken thousands of HIT competencies, hundreds of HIT roles, and many HIT areas and domains, and aggregated, catalogued and synthesized them into useful mappings and tools
Understand that implementation of new systems may require change to business processes or service redesign to maximize achievement of benefit
REWORDED COMPETENCY:
Promote positive change management techniques and good governance process in clinical workflows
Promote the need for good governance processes to ensure systems developed or procured are able to provide the functionality required to deliver the greatest benefits to the patient, end user and the organization

25. Creating the Framework for Interactive Tools and Pilots (DRAFT)
Operational Roles
Direct Patient Care
Administration/Law/Management/Finance
Health Informatics
Engineering/Information Systems
Research
Basic
Bereavement Counselor
Orderly
Nurse’s Aide
Intermediate
Advanced
Expert
Codes: AB01, AB02…
EU Role Names: bereavement counsellor (UK), chargé decompagnement (FR), Trauerbegleiter (DE), consejero de duelo (ES), consigliere lutto (IT)
Role Description: A bereavement counselor or coordinator monitors and manages the bereavement services for people dealing with terminal illness or death. They act as the main manager of the volunteers, medical staff, and others who are working with the bereaved. These professionals can work in a variety of settings including hospice, nursing homes, hospitals, and home health.
Job duties for this position include offering counseling, assessing needs, and explaining the services available to the bereaved. Additional job duties include organizing and scheduling support groups, creating bereavement materials, documenting bereavement services given to clients, and training new staff.
Competencies:
Be familiar with the concepts of primary and secondary health data
Locate and retrieve information in the electronic health record, according to your job role
Codes: AB01, AB02…
EU Role Names: medical orderly/ward assistant (UK), aide-soignant(e) (FR), Krankenwärter(in) (DE), camillera del hospital (ES), attendente (IT)
Role Description: Orderlies are often utilized in various hospital departments. Orderly duties can range in scope depending on the area of the health care facility they are employed. For that reason, duties can range from assisting in the physical restraint of combative patients, assisting physicians with the application of casts, transporting patients, shaving patients and providing other similar routine personal care
Competencies:
Be familiar with the concepts of primary and secondary health data
Locate and retrieve information in the electronic health record, according to your job role
Codes: AB01, AB02…
EU Role Names:* nurse aide (UK), soigne l'aide (FR), Krankenpflegehelfer(in) (DE), cuida al asistente (ES), infermieri aiutante (IT)
Role Description: Nurses' aides (NAs) work under the supervision of nurses or physicians to address the most fundamental elements of a patient’s care. They feed, dress, bathe and groom patients, contributing enormously to their sense of normalcy and well-being. NAs are sometimes given more medically-oriented duties such as measuring and recording temperature, blood pressure, and other vital signs. Nurses' aides also assist with the administrative duties and record-keeping that accompany patient care. 
Competencies:
Be familiar with the concepts of primary and secondary health data
Locate and retrieve information in the electronic health record, according to your job role
Add note to bottom of this slide: We are incorporating different naming conventions, also different role definitions, for various EU member countries, so there is not just one definition for all of EU
*We are incorporating different naming conventions, and also different role definitions, for various EU member countries, so there is not just one definition for all of EU

26. Supporting Concurrent Initiatives (DRAFT)
In addition to developing a framework and tools for HIT workforce development, our work also aims to enhance and support other parallel and complementary initiatives, including:
AHIMA - Global Health Workforce Council
AHIMA’s Career Tool
European e-Competence Framework
CAMEI
Technology Informatics Guiding Education Reform (TIGER Summit)
TransAtlantic Business Council
"NEW SKILLS AND NEW JOBS IN THE HEALTH CARE AND SOCIAL WORK SECTOR “: a project developed by 13 partners of 5 Member States in response to a European Tender of the 2009 Progress Program
Others

27. Next Steps (DRAFT) Communicate Progress to Stakeholders and Leadership
Draft White Paper for Peer Review and potential publication on Methodology and Process
Continue work on Formal and Informal Curriculum Mapping
Present at eHealth Week in Boston (Oct 21-22)
Finalize second domain Competency Mapping (Administration/Finance/Legal/Management)

28. Workforce Development Project Support Team (DRAFT)
US Point of Contacts
Mera Choi,
Jamie Parker,
Gayathri Jayawardena,
Christina Nguyen,
Amanda Merrill,
John Feikema,
EU Point of Contacts
Mary Cleary,
Benoit Abeloos,
Frank Cunningham,
US/EU Point of Contact
Rachelle Blake,

29. Initiative Resources (DRAFT)
EU-US Wiki Homepage
Join the Initiative
EU-US Initiative Reference Materials
Workforce Development Homepage